Research

Gaps in related to wildlife and environment affecting prevention and preparedness, 2007–2020 Catherine Machalaba,a Marcela Uhart,b Marie-Pierre Ryser-Degiorgisc & William B Karesha

Objective To describe and quantify the extent of wildlife and environment sector inclusion in country evaluation and prioritization tools for health security, and to provide practical recommendations for global and national action to improve pandemic prevention and preparedness. Methods To assess coverage of wildlife and other environmental aspects, we reviewed major health security reports (including World Organisation for Animal Health Performance of Veterinary Services reports, and World Health Organization Joint External Evaluations and follow-on National Action Plans for Health Security) published by 107 countries and territories. We extracted information on stated coverage gaps, wildlife surveillance systems and priority diseases. We also searched National Strategies and Action Plans published by 125 countries to assess whether or prevention activities were included. Findings We noted that the occurrence frequency of keywords indicative of wildlife, environment, biodiversity and factors varied with type of report and between countries. We found that more than half (57.9%, 62/107) of the reporting countries did not provide any evidence of a functional wildlife health surveillance programme. Most countries (83.2%, 89/107) indicated specific gaps in operations, coordination, scope or capacity. Only eight of the 125 countries (6.4%) publishing a National Biodiversity Strategy and Action Plan reported tangible activities related to wildlife health or zoonotic disease. Conclusion Overall, despite their importance for pandemic prevention, wildlife and environmental considerations are neglected in health security priorities and plans. Strengthening wildlife health capacity and operations should be emphasized in efforts to monitor and mitigate known and novel disease risks.

Introduction mammalian still undiscovered, overlooking wildlife health leaves a critical void in health security efforts and a Improved health security is crucial for global and national global vulnerability to accidental and intentional sources of health systems to counter infectious disease epidemics and biothreats.10,11 their wide-scale socioeconomic consequences. The importance Country-level mandates for environmental health are of a One Health multisectoral and collaborative approach – one often split across multiple government agencies, with a that recognizes the connection between the health of , high potential for fragmentation and gaps, and national animals and ecosystems – has been acknowledged for years fol- funding directed to wildlife health is extremely limited or lowing introduction of the term in the early 2000s.1 Although non-existent.3,12 A review of 18 national action plans on significant advancements in multisectoral coordination have documented the limited integration been made over the past decade, the overwhelming focus has of environmental considerations, noting that an incomplete been on and domestic animal health; scant attention application of the One Health approach may miss a key has been paid to the risks and impacts of zoonotic diseases at driver and hinder effective control strategies.13 This omission wildlife–human or wildlife–livestock interfaces, or to the role for antimicrobial resistance reflects what is perceived as a of changing environmental conditions.2,3 The consequences larger systematic under-representation of the environment of this neglect have been costly and deadly with thousands of sector in health security as a source of unaddressed risks and known zoonotic disease outbreaks in recent decades linked potential solutions. to wildlife, for example: human immunodeficiency and National One Health coordination platforms may offer acquired immunodeficiency syndrome, Lassa fever, mechanisms to address persistent capacity and implementa- virus disease, highly pathogenic avian influenzas, Nipah virus tion needs from all relevant sectors. Doing so will require disease, severe acute respiratory syndrome and practical, targeted entry points to integrate environmental disease 2019 (COVID-19).4–6 expertise and other resources to monitor and manage The exclusion of wildlife and environmental issues from pathogen spillover risks.14 We review relevant national-level is especially concerning as growing assessments and action plans to determine areas of cover- pressures on biodiversity and ecosystems facilitate new or age and gaps, and to identify opportunities to integrate the increasing exposure to wildlife, and high mobility through environment sector into global and national health security trade and travel enables the rapid spread of pathogens.6–8 A efforts. We also offer practical recommendations for global recent analysis based on global change trajectories projected and national action to enhance the surveillance of emerg- an increase by up to threefold of Ebola virus spillover events ing diseases and to improve pandemic prevention and and epidemics by 2070.9 With an estimated million-plus preparedness.

a EcoHealth Alliance, 520 Eighth Avenue, Suite 1200, New York, NY 10018, of America (USA). b One Health Institute, School of Veterinary Medicine, University of California, Davis, USA. c Centre for Fish and Wildlife Health, Department of Infectious Diseases and Pathobiology, University of Bern, Bern, . Correspondence to William B Karesh (email: karesh@​ecohealthalliance​.org). (Submitted: 6 July 2020 – Revised version received: 19 December 2020 – Accepted: 21 January 2021 – Published online: 2 March 2021 )

342 Bull World Health Organ 2021;99:342–350B | doi: http://dx.doi.org/10.2471/BLT.20.272690 Research Catherine Machalaba et al. Wildlife and environment gaps in pandemic prevention

Methods between countries because of recurring reports and Joint External Evaluations; updates to evaluation tools and because 12 countries (, , Eritrea, There currently exists no capacity as- these indicators were not specifically Lao People's Democratic Republic, Li- sessment tool for national wildlife or designed for wildlife or environmental beria, Myanmar, , Sierra Leone, environmental services that serves as considerations. Furthermore, we did not Sri Lanka, Uganda, United Republic of a parallel to available and want to present judgement; our aim is to Tanzania and United States of America) veterinary services evaluations.3,15 To help to identify weaknesses that can be published Joint External Evaluations gauge the extent of wildlife and envi- transformed into opportunities for im- and National Action Plans for Health ronmental coverage in zoonotic disease proving or strengthening health security. Security; and two countries (Australia efforts, we therefore reviewed published We also extracted information on and Nigeria) published all three types reports from key processes used to as- priority diseases for public or animal of report. sess national capacity, prioritize national health from the Joint External Evalu- We observed that the occurrence efforts and leverage programmatic fund- ations (data repository).16 Although frequency of search terms within reports ing for health security. Reviewed reports criteria for priority diseases are not varied with country and type of report: included those published by the World standardized across countries, the evalu- wild animal and/or wildlife occurred Organisation for Animal Health (OIE) ations provided an initial indication of in 58.3% (seven of 12 National Action on the Performance of Veterinary Ser- the types of diseases considered impor- Plans for Health Security) to 85.7% vices, and World Health Organization tant in the context of health security. (78 of 91 Joint External Evaluations); (WHO) Joint External Evaluation mis- Despite the fact that the United environment occurred in 53.1% (17 of sions and follow-on National Action Nations (UN) Convention on Biological 32 Performance of Veterinary Services Plans for Health Security (Table 1; avail- Diversity – the main intergovernmental reports) to 98.9% (90 of 91 Joint External able at: http://​www​.who​.int/​bulletin/​ treaty for biodiversity and ecosystem Evaluations); and One Health occurred volumes/99/​ 5/​ 20​ -272690​ ). conservation – has officially recognized in 18.8% (six of 32 Performance of We conducted a keyword search the value of a One Health approach, Veterinary Services reports) to 100% for terms inclusive of wildlife and signatory countries are not obliged to (all 12 National Action Plans for Health environmental risk and monitoring consider wildlife health or undertake Security; Fig. 1; data repository).16 We considerations (Table 1). We reviewed related activities. To assess the voluntary noted that the occurrence frequency of documents in their published language uptake of wildlife health considerations climate-related terms varied from 22.0% (English, French or Spanish) using in conservation planning and commit- (20 of 91 Joint External Evaluations) to keyword translations. We interpreted ments, we also reviewed the latest ver- 41.7% (five of 12 National Action Plans the mention of “animals” to be inher- sions of National Biodiversity Strategies for Health Security; data repository).16 ently biased towards domestic animals and Action Plans submitted under the More specific search terms used by (pets and livestock, validated by several Convention (if published in English), report type to assess topical coverage reports referring to “animals and wild- which serve as the primary mechanism ranged from 0% for biodiversity (no life”). We therefore screened specifically for national implementation (Table 1 mention in any of the National Action for “wildlife” and “wild animals”. Given and data repository).16 Plans for Health Security) to 87.5% for its prominence in the documents and All reports mentioned above pro- zoonotic and related terms (28 of 32 lack of specificity, we did not include vide an indication of the primary tools Performance of Veterinary Services the term “zoonotic” in the review of used by external and domestic funders reports) (Table 2). the WHO Joint External Evaluations to target investments in health security, Wildlife surveillance and National Action Plans for Health animal health, and biodiversity and Security. We excluded words in stan- ecosystem management, and to provide From our review of Performance of dard headings or introductions, as well a best estimate of existing efforts and Veterinary Services reports and Joint as non-substantive phrases using key- weaknesses. External Evaluations published during words in other contexts (e.g. “biosafety 2007–2019, of the 107 countries with at environment”). Our review focused on Results least one type of report, 45 (42.1%) pro- infectious diseases, excluding informa- Coverage of topics vided evidence of a functional wildlife tion on chemical emergencies. disease surveillance programme or other To identify stated weaknesses and We identified 32 Performance of Veteri- wildlife-related activities. We noted that evidence of an operational surveil- nary Services reports (published 2007– the scope varied broadly, and in some lance system for wildlife disease and/or 2019), 91 Joint External Evaluations cases was limited to selected diseases wildlife pathogen screening, we supple- (2016–2019) and 12 National Action (e.g. surveillance in wild mented keyword searches by text review Plans for Health Security (2017–2019) birds). We could not determine the qual- (primarily the chapter on prevention of that are publicly available from 107 ity or relevance of reported activities, or zoonotic diseases in the Joint External countries or territories (Table 1 and whether they were sustained over time, Evaluations for strengths, gaps and data repository).16 A total of 16 coun- highlighting the snapshot of as- recommendations for priority actions). tries (Australia, Botswana, , sessments and a possible lack of regular We recorded search terms as “present” , Congo, Côte communication between sectors. or “absent” (available in the data reposi- d’Ivoire, Eswatini, , , , Of all assessed countries, 83.2% tory).16 We did not compare scores from Namibia, Nigeria, , , (89/107) explicitly cited specific gaps the Joint External Evaluations and Per- South and Viet Nam) published or did not include any wildlife coverage. formance of Veterinary Services reports both Performance of Veterinary Services We grouped these cited gaps related to

Bull World Health Organ 2021;99:342–350B| doi: http://dx.doi.org/10.2471/BLT.20.272690 343 Research Wildlife and environment gaps in pandemic prevention Catherine Machalaba et al.

Fig. 1. Frequency occurrence of search terms in Performance of Veterinary Services disease list had not yet been developed. reports, Joint External Evaluations and National Action Plans for Health Security While transmission dynamics are locally in study of wildlife and environment inclusion in pandemic prevention and dependent, we noted that the majority preparedness, 2007–2019 of diseases prioritized by countries have environmental determinants that are important for disease management. For 90 89 12 example, wild animals play a significant 100 11 role as reservoirs or maintenance hosts 90 27 78

ts (%) for viral pathogens such as avian in- 80 fluenza viruses (waterfowl),17 Marburg 70 7 and Nipah viruses (certain species of 60 17 frugivorous ),18,19 and Lassa and 50 5 viruses (various species of 40 rodents),20,21 reinforcing the potential 30 20 value of the involvement of the environ- tion of published repor 6 20 ment and wildlife sectors when design- 10 Propor ing health security programmes. 0 Wild animal and/or EnvironmentOne Health and/or wildlife climate Discussion Search term Performance of Veterinary Services (n = 32) Joint External Evaluation (n = 91) Despite the likelihood of devastating impacts from epidemics following a National Action Plan for Health Security (n = 12) spillover event from wildlife to humans, Note: The Performance of Veterinary Services reports were not reviewed for the search terms weather as has occurred with several emerging 22–24 and/or climate. diseases in recent decades, countries are failing to address the environmental components of current health threats. Table 2. Coverage of search terms in specific report types in study of wildlife and Indeed, our findings indicate that wild- environment inclusion in pandemic prevention and preparedness, 2007–2019 life and environmental considerations remain absent from even the most recent Search term Report type No. (%) of health security capacity assessments and country reports plans. Moreover, for some countries Zoonotic and/or Performance of Veterinary Services (n = 32) 28 (87.5) where scientific publications or personal zoonoses communications report the existence of Risk factors Performance of Veterinary Services (n = 32) 4 (12.5) wildlife health surveillance activities, Vector Joint External Evaluation (n = 91) 76 (83.5) relevant information was not provided Reservoir Joint External Evaluation (n = 91) 25 (27.5) in the official reports. Our findings Biodiversity National Action Plans for Health Security 0 (0.0) reinforce the impression that wildlife (n = 12) is not a priority in the context of health security frameworks. Where included, deficits in operations and intersectoral wildlife health into categories most for 6.4% (8/125) of countries (Box 2). coordination seem to be the rule rather relevant to zoonoses prevention and One Health was only mentioned in the than the exception. Rather than building control (Box 1). National Biodiversity Strategy and Ac- dedicated systems at country, regional Biodiversity tion Plan published by Botswana. and intergovernmental levels, efforts ap- Priority diseases pear largely ad hoc or driven by external Our keyword search of the latest Eng- research support. lish-language National Biodiversity Among the diseases of public and/or It is encouraging that a few countries Strategies and Action Plans submitted animal health importance mentioned have set relatively ambitious and specific to the Convention on Biological Diver- in the 91 Joint External Evaluations, targets for developing wildlife surveil- sity revealed that only 8.0% (10/125) 40 diseases (or disease categories) were lance frameworks (e.g. ’s National of countries included wildlife health cited by two or more countries (data re- Action Plan for Health Security) and and/or zoonotic disease content. When pository).16 Listings ranged from patho- that specific risk interfaces have been wildlife health content was included, the gens to specific diseases and syndromes identified (e.g. illegal in links between health and biodiversity in (e.g. viral haemorrhagic fevers). , Viet Nam’s Performance of Veterinary the context of disease threats were main- brucellosis, anthrax, and avian and/or Services report). However, implementa- ly covered in broad terms (e.g. wild- zoonotic influenza were each listed by tion requires dedicated international life–livestock conflicts, wildlife–human at least half of the reporting countries. commitment to support countries in interactions, decline of certain species or Countries reported either active surveil- building wildlife health capacity. Even plant pests). Country-specific wildlife lance in animals and humans for prior- nations with the most developed wildlife health or programmes and activities ity diseases, surveillance of diseases in health systems acknowledge challenges, related to zoonotic diseases were noted humans only or that a formal priority gaps and the need for expanded capac-

344 Bull World Health Organ 2021;99:342–350B| doi: http://dx.doi.org/10.2471/BLT.20.272690 Research Catherine Machalaba et al. Wildlife and environment gaps in pandemic prevention

25,26 ity. Our findings are not meant as a Box 1. Gaps relevant to wildlife health (as specifically referred to or inferred) in country critique of countries, but rather as an assessments and plans, and implications, in study of wildlife and environment opportunity for health security actors to inclusion in pandemic prevention and preparedness, 2007–2019 consider new pathways to advance pre- vention and detection functions by engag- • Poor integration and/or coordination: lack of awareness among sectors; high potential for ing and strengthening other sectors. As gaps in mandates, budgets and activities; missed opportunities to synergize National Action Plans for Health Security • Not mentioned or insufficient information to assess gaps: wildlife not considered in risk are branded as multisectoral, all attempts assessments, health security plans or implementation efforts should be made to ensure sufficient inclu- • Wildlife sector not included in plans, training and/or operations: wildlife and environment sion of the environmental sector. considerations omitted; lack of opportunities for wildlife sector to understand relevance to health security; possibly inadequate, inappropriate, inefficient or detrimental disease We observed that although coun- control measures tries list several wildlife-associated • Not operational: no wildlife health and/or disease input to surveillance system; no baseline priority diseases with possibly severe information; no or low capacity and resources consequences, including the potential to • Limited capacity (including workforce shortages): inability to perform necessary surveillance become a pandemic, efforts in health se- and risk reduction activities; insufficient workforce; increased health risks curity are generally focused on diseases • Pilot and/or limited scope (disease or geographic scale): surveillance ad hoc and not of domestic animal origin. It is unclear comprehensive for all relevant species, pathogens and risk interfaces; lack of general whether this is because of (i) the actual surveillance implies poor early-detection capacities; poor understanding and monitoring relative disease burden in the country; of disease and/or pathogen occurrence and associated national and transboundary health (ii) the perceived risk or feared impact; risks; financing not sustained; capacity and activities may not be transferrable to public sector or (iii) a bias in assessment and planning • Vulnerability and/or risk targeting only: risk reduction measures not implemented; may not processes because of a limited familiar- be comprehensive or reflect evolving risks without ongoing monitoring inputs ity with monitoring and mitigation measures outside of human health and veterinary services. The lack of attention Box 2. List of specific wildlife health activities and programmes included in the latest paid to novel (in particular, wildlife- versions of National Biodiversity Strategies and Action Plans of 125 countries associated) pathogens, even in recently reporting in English, in study of wildlife and environment inclusion in pandemic reported priority disease lists, translates prevention and preparedness, 2010–2020 into preparedness deficits from risk re- • : management of the virtual Center for Information on Wildlife Health duction activities to diagnostic capabili- • : monitoring and warning system for pathogenic and epidemic microorganisms with ties. For example, only 9.9% (9/91) of the a database, assessment of impacts on biodiversity, and emergency response capabilities assessed countries listed • Islamic Republic of Iran: intended development of a comprehensive plan for emerging or associated diseases as priorities in environmental issues that includes wildlife diseases their Joint External Evaluations, despite • Liberia: wildlife disease management and surveillance identified as an area of need for prior warnings about the human and long-term expertise training and development 27,28 animal health threat that they pose. • Republic of Korea: opening and operation of the National Wildlife Health Research Center, Several countries prioritize climate- establishment of the Second Basic Plan for Wildlife Disease Management, development and and environment-sensitive diseases implementation of avian influenza countermeasures for wild birds, conducting of surveys (notably echinococcosis, leptospirosis, and research on wildlife diseases, and strengthening the response and management system yellow fever and Rift Valley fever),29–32 • Rwanda: wildlife health and disease monitoring activities through a nongovernmental but climate is poorly represented in organization mentioned under institutional framework for groups involved in biodiversity evaluations and plans. Prioritization management exercises may benefit from consider- • Uganda: frameworks cited that include prevention and control of diseases presenting a ation of relevant interfaces and risk risk to animals and humans factors for emergence, which may be • : federal law on zoonotic diseases listed as a relevant for the highly country-specific, to guide prior- Aichi biodiversity targets ity disease selection and appropriate interventions. The anticipated gains Our review had several limitations. surveillance are complementary, and may benefit a range of objectives for First, for simplicity, we used the terms both are necessary for a comprehensive emerging and endemic diseases, for wildlife health and disease or pathogen surveillance programme.38 Alternative example: understanding baseline risk; surveillance interchangeably. These search terms may have captured a related enhancing knowledge of pathogen and terms may have nuanced meanings and scope of activities not reflected in our host ecology; forecasting and early serve different purposes in practice. For findings. Second, in practice, certain warning; sentinel detection; and target- example, wildlife disease surveillance operations may be shared between coun- ing high-risk conditions to reduce the may detect new health threats to animal tries (e.g. surveillance in Liechtenstein frequency of spillover events.33–36 The populations (general, event-based or and Switzerland). We did not review evolving threats and uncertainty rep- clinical, and syndromic surveillance), sources of information on subnational resented by environmental change will while pathogen surveillance may expand pandemic prevention, as international require enhancements in wildlife disease knowledge of pathogens circulating in frameworks (e.g. the International monitoring in both industrialized and an area; however, we note that wild- Health Regulations) have emphasized non-industrialized settings.25,37 life disease surveillance and pathogen national-level core competencies and,

Bull World Health Organ 2021;99:342–350B| doi: http://dx.doi.org/10.2471/BLT.20.272690 345 Research Wildlife and environment gaps in pandemic prevention Catherine Machalaba et al. to date, there is no standard subnational and animal health but lacking any call A key challenge is that an insti- approach allowing for comparisons. to action for the environment sector tutional mandate for wildlife health is However, select examples of disease to specifically engage in preparedness not captured by any specific intergov- prioritization exercises and provincial initiatives.43 This absence, alongside ernmental agency. Without formal re- programmes have been reported, and emphasis on preparedness for health sponsibility for wildlife health, there are will ultimately be critical for expansion emergencies rather than risk reduction, significant gaps in the implementation and sustainment of efforts.39,40 Third, demonstrates that dedicated effort is of surveillance programmes spanning the static and non-standardized nature required to correct for the continued risk assessment, reporting, investigation of assessments only provides a snapshot omission of the wildlife and environ- and management decisions. A respon- of capacity and activities at any point ment sectors in recovery from the sible authority and budget source for all in time; we could therefore not assess COVID-19 pandemic. Accordingly, a wildlife and environmental health func- progress since the publication of any report issued by the Intergovernmental tions may not be readily identified, given report. Further, reporting tools were Science-Policy Platform on Biodiver- the typical scope of natural resource continuously being updated throughout sity and Ecosystem Services has noted management (e.g. biodiversity and eco- the period covered by the evaluation and the potential value of a shift towards system monitoring may be in place, but planning reports (2007–2020), meaning pandemic prevention that explicitly in- not disease/pathogen surveillance) and that measuring progress for any particu- tegrates biodiversity and health science limited inclusion of wild animals in vet- lar country was not possible. Fourth, we to inform decision-making.8 erinary services.12 A review of mandates acknowledge possible reporting gaps is needed to assign responsibility and (> 100 countries completed Performance of Veterinary Services reports, but only 32 elected to make their reports public). Box 3. Recommendations to strengthen wildlife health capacity arising from study of Furthermore, we did not perform a sys- wildlife and environment inclusion in pandemic prevention and preparedness, tematic assessment of all gaps present, 2020 but rather inferred the main gaps based Global infrastructure on those recognized and self-reported in reports; our interpretations may there- • Partnerships: empower environment entities to contribute to intergovernmental One Health and health security initiatives to ensure equal and systematic inclusion fore be subjective. However, our findings • Assessment and planning tools: (i) include a dedicated space for a wildlife health expert in are consistent with the well-recognized Joint External Evaluation and Performance of Veterinary Services assessment teams, and and chronic gaps in surveillance of involve zoonotic disease experts in National Biodiversity Strategies and Action Plans; (ii) add wildlife diseases previously reported by framing or questions specific to wildlife, and relevant risk monitoring and mitigation of others,26,41 and highlight the need for environmentally sensitive wildlife or vector-borne diseases; and (iii) develop an assessment further assessment and benchmarking tool to target wildlife and ecosystem management capacity to supplement public health of wildlife health systems to reduce and veterinary services assessments pandemic risk. • Resource mobilization: dedicate funding to wildlife health capacity development, or target Our study benefited from several a portion of One Health funds to be directed to implementation activities strengths. First, rather than relying on • Investigation and reporting: implement systems for (i) immediate notification of wildlife complex modelling tools, the evidence mass morbidity or mortality events (annual reporting of selected wildlife disease events in the self-reported assessments was to the OIE is currently voluntary via the World Animal Health Information System - Wild Interface); and (ii) investigation of wildlife disease events (parallel to the Global Outbreak straightforward to extract without the Alert and Response Network in human health events) introduction of errors or possibility of • Training: (i) offer field-based epidemiology training programmes for wildlife veterinarians; misinterpretation. Second, our inclusion and (ii) report on number of qualified wildlife veterinarians and/or wildlife health of evaluations and plans from multiple professionals by country (parallel or subset of veterinarians and para-veterinarians reporting sectors – human health, animal health to the OIE) and the environment – is consistent • Implementation: develop guidance for accessing and interpreting wildlife health data to with the One Health approach needed assess threat to public health, domestic animal health, and biodiversity and ecosystems to examine this topic. Overall, the necessity of multisec- National and subnational toral collaboration for health security is • Planning: develop wildlife health sector (institutional mandates, training, resourcing and workforce development) increasingly recognized. The UN Gen- eral Assembly resolution A/74/306, • Reporting: establish mechanism(s) for centralized reporting of wildlife health and/or disease research to a national entity adopted in September 2020, calls for a climate- and environment-sensitive • Risk assessment and monitoring: (i) set up arrangements with laboratories for testing of wildlife samples (and implement appropriate export and import agreements if approach to building back better in international); (ii) perform risk profiling and assessment of major wildlife–domestic animal COVID-19 recovery efforts, including and wildlife–human interfaces (e.g. markets) to identify high-risk transmission the protection of wildlife.42 However, interfaces; (iii) perform risk profiling and assessment for diseases in native and introduced in its 2020 Annual Report, the Global wildlife species to inform conservation planning, livestock and zoonotic disease Preparedness Monitoring Board issued prioritization; (iv) require consultation of government wildlife entity(ies) or expert scientists a call for “robust ”, in case of human or domestic animal disease connected to environmental resources; including predicting and detecting and (v) integrate wildlife and other environment information into a surveillance system leveraging local stakeholders (e.g. park rangers, community eco-monitors and hunters) pathogen emergence via a One Health approach, broadly mentioning human OIE: World Organisation for Animal Health.

346 Bull World Health Organ 2021;99:342–350B| doi: http://dx.doi.org/10.2471/BLT.20.272690 Research Catherine Machalaba et al. Wildlife and environment gaps in pandemic prevention develop plans for short-term pragmatic and animal health systems and multi- this field at different levelsBox ( 3). Sup- stopgaps and long-term capacity and sectoral coordination mechanisms in port to countries in systematic planning workforce strengthening. 16 central and west African countries.48 and pragmatic implementation could be As a first action, existing health Several nominal changes can help catalysed through a multisectoral health security programmes should be re- ensure the visibility of wildlife and of security convening and priority-setting viewed for targeted entry points for the broader considerations for environmen- body, such as the Global Health Security environment sector. At a global level, a tal risk mitigation in health security. Agenda. dedicated intergovernmental environ- We encourage public health and animal As evidenced by the COVID-19 ment partner is needed to ensure repre- health sectors to examine existing tools pandemic, there are unacceptable risks sentation in relevant decisions, guidance and programmes (e.g. Performance of in neglecting the wildlife and environ- and programmes. Expanding on prior Veterinary Services reports and Joint mental drivers of pathogen spillover. intergovernmental coordination,44 the External Evaluations) in the immediate Wildlife health surveillance is para- launch of a high-level One Health expert term, and to continue to take steps to mount to the success of the One Health group has been proposed for 2021 by support their line ministries in identify- movement in preventing, detecting and WHO, OIE, UN Food and ing areas of value for collaboration with mitigating known and novel zoonotic Organization, and UN Environment the environment sector. For example, disease risks. We appeal to countries Programme.45 Success will require sus- the OIE has developed a framework to and multisectoral panels to urgently tained efforts and resourcing, equitable enhance veterinary service capacities in acknowledge and remediate these gaps representation and, ideally, alignment managing risks from emerging diseases in global and national health security with the sustainable development goals while protecting wildlife.49 Assessment priorities and efforts. for broader benefits. and operational tools have evolved in Evidence syntheses and guidance important ways since their first itera- Acknowledgements resources have been produced through tions to encompass greater scope, signal- We thank the countries and assessment the Convention on Biological Diversity– ling that future editions may facilitate teams for making their reports available. WHO Joint Work Programme on Biodi- meaningful intersectoral collaboration. We thank Linda Oliwa. MU, MPRD and versity and Health, with the Convention Future versions can expand on compe- WBK are also affiliated to the World -Or also adopting guidance on integrating tencies for risk reduction, particularly ganisation for Animal Health Working biodiversity considerations into a One those related to disease emergence. Spe- Group on Wildlife. Health approach.46,47 Efforts are needed cifically, greater attention must be paid to systematically translate agreements to wildlife and environmental change as Funding: This work was funded by the and knowledge products into country- the major source of emerging zoonoses.4 United States Agency for International level planning and implementation. One Similarly, involving both public health Development Emerging Pandemic possible path is via add-on funding of and animal health authorities in the Threats PREDICT project (Cooperative existing bilateral or multilateral health design and implementation of National Agreement No. AID-OAA-A-14-00102). security projects at national or regional Biodiversity Strategies and Action Plans levels, such as the Regional may enhance the health security value of Competing interests: None declared. Disease Surveillance System Enhance- biodiversity-focused activities. We pro- ment programme that supports human vide a set of initial ideas for developing

ملخص فجوات األمن الصحي املرتبطة باحلياة الربية والبيئة والتي تؤثر عىل الوقاية من جائحة واالستعداد هلا، 2020 - 2007 الغرض وصف وإحصاء مدى مشاركة قطاع احلياة الربية والبيئة يف النتائج الحظنا أن معدل تكرار الكلامت األساسية التي تشري أدوات التقييم وحتديد األولويات يف البلد لألمن الصحي، وتقديم إىل احلياة الربية والبيئة والتنوع احليوي والعوامل املناخية اختلف توصيات عملية للعمل العاملي والوطني لتحسني الوقاية من الوباء عىل حسب نوع التقرير ويف ما بني الدول. وجدنا أن أكثر من نصف ) / , %( واالستعداد له. الدول التي قدمت ًتقريرا 9 57، 62 107 مل تقدم أي دليل الطريقة لتقييم تغطية احلياة الربية واجلوانب البيئية األخرى، عىل وجود برنامج فعال ملراقبة صحة احلياة الربية. أشارت معظم راجعنا التقارير الرئيسية عن األمن الصحي العاملي )بام يف ذلك الدول )%83,2، 89/107( إىل فجوات حمددة يف العمليات أو التقارير عن أداء اخلدمات البيطرية الصادرة من املنظمة العاملية التنسيق أو النطاق أو السعة. أبلغت 8 دول فقط من 125 دولة لصحة احليوان، والتقييامت اخلارجية املشرتكة الصادرة عن منظمة )%6,4( نرشت اسرتاتيجية وخطة عمل وطنيتني للتنوع احليوي الصحة العاملية ومتابعة خطط العمل الوطنية لألمن الصحي( ترتبطان بصحة احلياة الربية أو املرض حيواين املصدر. واملنشورة من جانب 107 دول ومناطق. استقينا معلومات عن االستنتاج تتعرض االعتبارات اخلاصة باحلياة الربية الفجوات املذكورة يف التغطية ونظم مراقبة احلياة الربية واألمراض واالعتبارات البيئية للتجاهل بشكل عام يف األولويات واخلطط التي هلا األولوية. كام أننا بحثنا يف االسرتاتيجيات وخطط العمل اخلاصة باألمن الصحي عىل الرغم من أمهيتها للوقاية من اجلائحة. الوطنية للتنوع احليوي املنشورة من جانب 125 دولة لتقييم ما إذا ينبغي التأكيد عىل تعزيز القدرات والعمليات اخلاصة بصحة احلياة كانت نشاطات مراقبة األمراض أو الوقاية منها مدرجة. الربية يف جهود مبادرة الصحة الواحدة ملراقبة املخاطر الناجتة عن األمراض املعروفة واجلديدة واحلد منها.

Bull World Health Organ 2021;99:342–350B| doi: http://dx.doi.org/10.2471/BLT.20.272690 347 Research Wildlife and environment gaps in pandemic prevention Catherine Machalaba et al.

摘要 2007–2020 年间影响流行病预防和防范的野生动物和环境相关卫生安全差距 目的 旨在描述和量化国家评估卫生安全及为其选择优 区而异。我们发现，超过一半 (57.9％ , 62/107) 的报告 选工具时对野生动物和环境因素的重视程度，并为全 国家未提供任何有效的野生动物卫生监测计划证据。 球和国家采取行动以加强流行病预防和防范提供切实 研究表明，大多数国家 (83.2％ , 89/107) 特别是在行动、 可行的建议。 协作、范围或能力方面存在差距。在发布国家生物 方法 我们回顾了 107 个国家和地区发表的主要卫生安 多样性战略和行动计划的 125 个国家中，仅 8 个国家 全报告（包括世界动物卫生组织兽医服务体系效能报 (6.4％ ) 就野生动物卫生或人畜共患病报告了相关具体 告以及世界卫生组织联合外部评估和后续的《国家卫 行动。 生安全行动计划》），对野生动物和其他环境因素的覆 结论 总之，尽管野生动物和环境因素在预防流行病方 盖面进行了评估。我们提取了与上述覆盖面差距、野 面具有重要意义，但在卫生安全重点和计划中却未得 生动物监测系统和重点疾病相关的信息。我们还搜索 到重视。在“同一个健康”行动中，应着重于强化野 了 125 个国家 / 地区发布的国家生物多样性战略和行 生动物健康防疫能力和相关举措，以监测并减轻已知 动计划，以评估是否包括疾病监测或预防行为。 和新型疾病风险。 结果 我们注意到，野生动物、环境、生物多样性和气 候因素相关关键字的出现频率因报告类型和国家 / 地

Résumé Impact des lacunes de sécurité sanitaire liées à la faune sauvage et l'environnement sur les activités de préparation et de prévention des pandémies, 2007–2020 Objectif Décrire et déterminer dans quelle mesure la faune sauvage et Résultats Nous avons constaté que la fréquence d'apparition de mots l'environnement sont intégrés aux outils d'évaluation et de définition des clés faisant référence à la faune sauvage, l'environnement, la biodiversité priorités des pays dans le domaine de la sécurité sanitaire ; formuler des et les facteurs climatiques variait en fonction du type de rapport et recommandations pratiques pour entreprendre des actions nationales du pays. Plus de la moitié (57,9%, 62/107) des pays d'où provenaient et internationales visant à mieux prévenir les pandémies et à assurer les rapports ne mentionnaient aucune indication de l'existence d'un une meilleure préparation. programme contrôlant le bon fonctionnement de la faune sauvage. La Méthodes Afin d'évaluer la prise en considération de la faune sauvage et plupart des pays (83,2%, 89/107) ont signalé des lacunes spécifiques d'autres aspects environnementaux, nous avons examiné les principaux au niveau des opérations, de la coordination, du cadre ou des capacités. rapports de sécurité sanitaire (notamment les rapports de performance Seuls 8 pays sur 125 (6,4%) ayant publié une stratégie nationale et un des services vétérinaires de l'Organisation Mondiale de la Santé animale, plan d'action pour la biodiversité ont fait état d'activités tangibles liées les évaluations externes conjointes de l'Organisation mondiale de la à la santé des espèces sauvages ou aux zoonoses. Santé et le suivi des Plans d'action nationaux pour la sécurité sanitaire) Conclusion Globalement, malgré leur importance en matière de publiés par 107 pays et territoires. Nous y avons prélevé des informations prévention des pandémies, les considérations relatives à la faune sur le manque de couverture affiché, les systèmes de surveillance de la sauvage et à l'environnement font rarement partie des priorités et faune sauvage et les maladies prioritaires. Nous avons également étudié plans de sécurité sanitaire. Le renforcement des capacités et opérations les stratégies nationales et plans d'action pour la biodiversité parus dans préservant la santé des espèces sauvages devrait faire partie intégrante 125 pays en vue d'y déceler d'éventuelles activités de prévention et de des efforts de l'initiative «One Health» destinée à surveiller et limiter les surveillance des maladies. risques de maladies, qu'ils soient connus ou émergents.

Резюме Недостатки безопасности здравоохранения, связанные с дикой природой и окружающей средой, влияющие на предотвращение пандемии и обеспечение готовности к ней, 2007–2020 гг. Цель Описать и количественно оценить степень включения извлечена информация о заявленных недостатках относительно сектора дикой природы и окружающей среды в инструменты освещения событий, систем наблюдения за дикой природой и оценки и определения приоритетов в области безопасности приоритетных болезней. Также были изучены национальные здравоохранения стран, а также предоставить практические стратегии и планы действий в области биоразнообразия, рекомендации по глобальным и национальным действиям по опубликованные 125 странами, чтобы оценить, включены ли в них улучшению профилактики пандемий и обеспечению готовности мероприятия по эпиднадзору или профилактике заболеваний. к ним. Результаты Авторы отметили, что частота встречаемости ключевых Методы Чтобы оценить освещение событий относительно дикой слов, указывающих на дикую природу, окружающую среду, природы и других аспектов окружающей среды, авторы изучили биоразнообразие и климатические факторы, варьировалась в основные отчеты о безопасности здравоохранения (включая зависимости от типа отчета и между странами. Было обнаружено, отчеты Всемирной организации по охране здоровья животных, что более половины стран (57,9%, 62/107), опубликовавших а также совместные внешние оценки Всемирной организации отчет, не предоставили ни одного доказательства наличия здравоохранения и последующие национальные планы функциональной программы наблюдения за здоровьем дикой действий по обеспечению безопасности здравоохранения), природы. Большинство стран (83,2%, 89/107) указали конкретные опубликованные 107 странами и регионами. Авторами была недостатки в работе, координировании, сфере охвата или

348 Bull World Health Organ 2021;99:342–350B| doi: http://dx.doi.org/10.2471/BLT.20.272690 Research Catherine Machalaba et al. Wildlife and environment gaps in pandemic prevention

потенциале. Только 8 из 125 стран (6,4%), опубликовавших игнорируются в приоритетах и планах обеспечения безопасности Национальную стратегию и план действий по сохранению здравоохранения. Укрепление потенциала и действий в области биологического многообразия, сообщили о реальных охраны здоровья дикой природы должно быть выделено в мероприятиях, связанных со здоровьем дикой природы или рамках инициативы ВОЗ «Единое Здоровье» по мониторингу и зоонозными заболеваниями. смягчению известных и новых рисков заболеваний. Вывод В целом, несмотря на их важность для предотвращения пандемии, обсуждения дикой природы и окружающей среды

Resumen Impacto de las brechas en seguridad sanitaria relacionadas con la fauna silvestre y el medio ambiente para la preparación ante y la prevención de pandemias, 2007-2020 Objetivo Describir y determinar el grado de integración de Resultados Comprobamos que la frecuencia de aparición de las la fauna silvestre y el medio ambiente en las herramientas de palabras clave referidas a la fauna silvestre el medio ambiente, la evaluación y priorización de la seguridad sanitaria de los países; biodiversidad y los factores climáticos fue variable según el tipo de ofrecer recomendaciones prácticas para las acciones nacionales e informe y el país. Más de la mitad (57,9%, 62/107) de los países de los internacionales orientadas a mejorar la prevención de pandemias y que proceden los informes no presentan evidencia de la existencia de garantizar una mejor preparación. un programa de vigilancia en fauna silvestre. La mayoría de los países Métodos Para evaluar la consideración de la fauna silvestre y otros (83,2%, 89/107) señalaron deficiencias específicas en las operaciones, aspectos medioambientales, hemos revisado los principales informes la coordinación, el marco o la capacidad. Solo 8 de los 125 países (6,4%) de seguridad sanitaria (incluidos los informes de rendimiento del que habían publicado una estrategia y un plan de acción nacionales Proceso de Prestaciones de los Servicios Veterinarios de la Organización para la biodiversidad informaron de actividades tangibles relacionadas Mundial de Sanidad Animal, las herramientas de evaluación externa con la salud de la fauna silvestre o las . conjunta de la Organización Mundial de la Salud y el seguimiento Conclusión En general, a pesar de su importancia en la prevención de los planes de acción nacionales en pro de la seguridad sanitaria) de pandemias, las consideraciones sobre la fauna silvestre y el medio publicados por 107 países y territorios. Se extrajo información sobre las ambiente rara vez se incluyen en las prioridades y planes de seguridad deficiencias de cobertura mencionadas, los sistemas de vigilancia en sanitaria. El refuerzo de las capacidades y funcionamiento en materia la fauna silvestre y las enfermedades prioritarias. También revisamos de salud de la fauna silvestre debe ser integrada a los esfuerzos Una las estrategias y los planes de acción nacionales sobre biodiversidad Salud para controlar y limitar el riesgo de enfermedades existentes y de 125 países para identificar posibles actividades de prevención y emergentes. control de enfermedades.

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350 Bull World Health Organ 2021;99:342–350B| doi: http://dx.doi.org/10.2471/BLT.20.272690 Research Catherine Machalaba et al. Wildlife and environment gaps in pandemic prevention . .) continues ( National Biodiversity Strategy and Action Strategy Plan Biodiversity National Convention on Biological Diversity on Biological Convention health, wildlife animal health, wild epidemic, Wild One Health zoonotic, disease, wildlife Specific activities

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Joint External Evaluation Evaluation Joint External World Health Organization World environment, reservoir, wildlife, English: wild animal, and/or climate One Health, weather, vector, all variations), capture to “climat” (as climatological meteorological (as “meteo”) environnement, réservoir, faune, sauvage, French: climat, une seule santé, vecteur, environnemental, (and météorologiques conditions météo, climatique, of weather (in the context temps variations), relevant time) to references and excluding best practices, Priority animal or human diseases, priority for actions recommendations gaps,

Performance of Veterinary ServicesVeterinary Performance of World Organisation for Animal for Organisation World Health and/ zoonotic wildlife, English: wild, risk environmental, or zoonoses, risk, One Health, factors, drivers, emerging faune sauvage(s), French: zoonose(s), zoonotique, (sauvage), risque(s), facteur(s) environnement, une seule favorisant), risque, (de émergent(e) santé, fauna, zoonótico, Spanish: silvestre, medio ambiente, zoonosis, de riesgo, factor(es) ambiente, emergente diseases of coordination, Areas under surveillance, gaps Search strategy and country reports reviewed by type of reporting tool in study of wildlife and environment inclusion in pandemic prevention and preparedness, 2007–2020 and preparedness, inclusion in pandemic prevention and environment type of reporting and country in study of wildlife by tool Search strategy reports reviewed Table 1. Table Tool body International terms Search Additional information compiled

Bull World Health Organ 2021;99:342–350B| doi: http://dx.doi.org/10.2471/BLT.20.272690 350A Research Wildlife and environment gaps in pandemic prevention Catherine Machalaba et al. ​ National Biodiversity Strategy and Action Strategy Plan Biodiversity National c Afghanistan, , Angola, Antigua and Barbuda, Albania, Angola, Antigua Afghanistan, , , Bahrain, , Australia, Bhutan, Bosnia Belize, , , , Brunei Darussalam, Botswana, Brazil, and Herzegovina, China, Canada, Cameroon, , Verde, Cabo Republic of Korea, People's Democratic Czechia, , , Eswatini, , Eritrea, Dominica, , , Gambia, , France, , , Guyana, Guinea-Bissau, Grenada, Ghana, , India,, , Iran (Islamic Republic of), Iraq, Kiribati, , Jamaica, Japan, , Italy, Ireland, Liberia, , Republic, Democratic People's Lao , Malawi, Lithuania, , Liechtenstein, States Malta, (Federated Micronesia Mauritius, Maldives, of), Myanmar, Mozambique, Mongolia, , , , Nepal, Namibia, Nauru, Nigeria, Palau, Niue, North , Macedonia, , Republic of Republic of Korea, , , Philippines, Rwanda, Saint ,, Russian Federation, Samoa, and the Grenadines, Vincent Kitts Saint and Nevis, Serbia, Seychelles, and Principe, Tome Sao San Marino, , Solomon Islands, Singapore, Leone, Sierra Somalia, South , Sudan, Sri Lanka, Sudan, , Suriname, , , Switzerland, Uganda, Tuvalu, Turkey, Trinidad and Tobago, Timor-Leste, Kingdom, United United Emirates, Arab United , Zambia, Yemen, Nam, Viet , Tanzania, Republic of Zimbabwe 125 2010–2020 2020 9 May ​ wwwhttps:// ​ nbsap/ about/ latest/ ​ .cbd .int/

b Security National Action Plan for Health Action Health National Plan for Australia, Benin, Eritrea, Lao Lao Benin, Eritrea, Australia, Republic, Democratic People's 12 2017–2019 13 October 2019 ​ extranethttps:// ​ sph/ ​ .who .int/ country Liberia, Myanmar, Nigeria, Sierra Liberia, Myanmar, Sri Lanka, Uganda, United Leone, States United Tanzania, Republic of Joint External Evaluation Evaluation Joint External ​ Afghanistan, Albania, Armenia, Australia, Bahrain, Bahrain, Albania, Armenia, Australia, Afghanistan, Bangladesh, Benin, Belgium, Bhutan, Botswana, Canada, Cameroon, Burundi, Cambodia, , Congo, Comoros, , Republic, African Central Democratic , d'Ivoire, Côte Gambia, Ethiopia, Finland, Eswatini, , Eritrea, Ghana, Guinea, Indonesia, Japan, Jordan, Iraq, Democratic People's Lao Kyrgyzstan, Kuwait, Kenya, Liberia, , Lesotho, , Lebanon, Republic, , Maldives, Malawi, Lithuania, Madagascar, States , (Federated Micronesia Mauritius, of), Myanmar, Mozambique, Mongolia, , Nigeria, ,Namibia, , , Republic of Korea, Qatar, Philippines, Pakistan, Republic Rwanda, of Moldova, , , , Singapore, Leone, Sierra Serbia, Seychelles, Somalia, South South Africa, Sudan, Sri Lanka, Sudan, Switzerland and Timor-Leste, Thailand, Liechtenstein, Arab Uganda, United , , Togo, States, United Tanzania, Republic of United Emirates, Zimbabwe Zanzibar, Nam, Zambia, Viet 91 2016–2019 13 October 2019 ​ mission ​ wwwhttps:// ​ ihr/ procedures/ ​ .who .int/ -reports/ ​ en/ ​ Performance of Veterinary ServicesVeterinary Performance of , Australia, Belarus, Belize, Belize, Belarus, Australia, Argentina, of), State Bolivia (Plurinational Central Canada, Botswana, Brazil, Congo, , Republic, African Guinea, Eswatini, d’Ivoire, Côte India, Haiti, , Guinea-Bissau, Namibia, Japan, Kenya, Israel, Nigeria,New Caledonia, Panama, Rwanda, Seychelles, Paraguay, Republic, Arab South Syrian Africa, Viet Nam Uruguay, 32 2007–2019 8 July 2019 ​ wwwhttps:// ​ solidarity/​ .oie .int/ ​ ​ -evaluations/pvs ​ -evaluation​ pvs ​ -reports/ a a ) continued Lao People's Democratic Republic had a National Plan for Emerging Infectious Diseases, Public Health Emergencies and Health Security implementation mission report posted in lieu of a National Action Plan for Health Security. and Health Security for Health Emergencies mission report Action Plan in lieu of a National implementation posted Public Infectious Diseases, Emerging for Democratic Republic Plan had a National People's Lao The total number of countries with a National Biodiversity Strategy and Action Plan posted in any language was 169, excluding a report from the . the European a report 169, excluding from language was in any posted and Action Plan Biodiversity Strategy with a National number of countries total The Country or territory listings as reflected in available reports; grouping may differ by assessment and plan by assessment type. Country differ reports; may or territory available grouping in listings as reflected

a b c Tool and Countries assessed territories to (listings according reports)available countries no. Total and/or territories Report years on Accessed Source (. .

350B Bull World Health Organ 2021;99:342–350B| doi: http://dx.doi.org/10.2471/BLT.20.272690